Required Fields Marked With "
*
"
Note: For data collection purposes, please use proper punctuation (i.e. capitalization).
First Name:
*
Last Name:
*
CUSD Employee Number:
Please enter your five digit Employee ID #. (If you do not know your employee ID # please contact your office manager.)
*
Street Address:
*
City:
*
State:
*
Zip:
*
Phone (School):
*
Phone (Home):
*
Phone (Cell):
*
CUSD Email Address:
*
CUSD Employment Status:
Select One
Temporary
Probationary
Tenured
Substitute Teacher
Student Teacher
Cert. Hourly - Adult Ed.
Non-CUSD Employee
*
Current Position:
*
Current Assignment (School):
Select One
Adult Transition
Aliso Viejo MS
Ambuehl
ANHS
ANHS
Arroyo Vista
Arroyo Vista MS
Avila ES
AVMS
BAMS
Barcelona Hills
Bathgate
Benedict
Bergeson
Canyon Vista Elem
Carl Hankey
Carl Hankey MS
Castille
Chaparral
Concordia
Crown Valley
CVHS
Del Obispo
DHHS
Districtwide
DJAMS
Don Juan Avila Elem
FNMS
Fresh Start
George White
Hidden Hills
Junipero Serra High
Kinoshita
Ladera MS
Ladera Ranch Elem
Laguna Niguel Elem
Las Flores Elem
Las Flores MS
Las Palmas
LFMS
Lobo
LRMS
Malcolm
Marblehead
Marco Forster
MFMS
Moulton
Newhart MS
Niguel Hills
Oak Grove
Oso Grande
Oso Grande
Other
Palisades
R.H. Dana
R.H. Dana ENF
Reilly
San Juan
SCHS
Shorecliffs
SJHHS
SMS
Student Teacher
Substitute
THS
Tijeras Creek
VdMMS
Viejo
Vista Del Mar Elem
Vista Del Mar Mid
Wagon Wheel
Wood Canyon
Current Program Assignment (SDC, SDC/Autism, APE, etc...):
*
Please indicate other preferences below by listing 1,2,3, etc... according to your priorities. Select 0 for any that you will not consider.
LEVEL
Preschool:
Select One
0
1
2
3
4
5
6
*
K-2:
Select One
0
1
2
3
4
5
6
*
3-5:
Select One
0
1
2
3
4
5
6
*
6-8:
Select One
0
1
2
3
4
5
6
*
9-12:
Select One
0
1
2
3
4
5
6
*
Adult:
Select One
0
1
2
3
4
5
6
*
PROGRAM
DANA ENF:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/NS:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/SH:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/Autism:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/ED:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
SDC/DHH:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
APE:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Speech Path:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Other:
Select One
0
1
2
3
4
5
6
7
8
9
10
*
Specify (other):
*
I have read and agreed to the "Summer School Guidelines for Employment".
*
I am available for the entire Summer School session.
Elementary & Middle: June 23 through July 24
High School: June 23 through July 31st.
*
Signature:
*